Promoting colorectal cancer screening discussion: a randomized controlled trial

Am J Prev Med. 2013 Apr;44(4):325-329. doi: 10.1016/j.amepre.2012.11.032.


Background: Provider recommendation is a predictor of colorectal cancer (CRC) screening.

Purpose: To compare the effects of two clinic-based interventions on patient-provider discussions about CRC screening.

Design: Two-group RCT with data collected at baseline and 1 week post-intervention.

Setting/participants: African-American patients that were non-adherent to CRC screening recommendations (n=693) with a primary care visit between 2008 and 2010 in one of 11 urban primary care clinics.

Intervention: Participants received either a computer-delivered tailored CRC screening intervention or a nontailored informational brochure about CRC screening immediately prior to their primary care visit.

Main outcome measures: Between-group differences in odds of having had a CRC screening discussion about a colon test, with and without adjusting for demographic, clinic, health literacy, health belief, and social support variables, were examined as predictors of a CRC screening discussion using logistic regression. Intervention effects on CRC screening test order by PCPs were examined using logistic regression. Analyses were conducted in 2011 and 2012.

Results: Compared to the brochure group, greater proportions of those in the computer-delivered tailored intervention group reported having had a discussion with their provider about CRC screening (63% vs 48%, OR=1.81, p<0.001). Predictors of a discussion about CRC screening included computer group participation, younger age, reason for visit, being unmarried, colonoscopy self-efficacy, and family member/friend recommendation (all p-values <0.05).

Conclusions: The computer-delivered tailored intervention was more effective than a nontailored brochure at stimulating patient-provider discussions about CRC screening. Those who received the computer-delivered intervention also were more likely to have a CRC screening test (fecal occult blood test or colonoscopy) ordered by their PCP.

Trial registration: This study is registered at NCT00672828.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • African Americans / statistics & numerical data
  • Age Factors
  • Colonoscopy / methods
  • Colorectal Neoplasms / diagnosis*
  • Computers
  • Female
  • Health Promotion / methods
  • Humans
  • Logistic Models
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Occult Blood
  • Pamphlets
  • Patient Compliance*
  • Physician-Patient Relations
  • Primary Health Care / organization & administration*
  • Self Efficacy
  • Social Support
  • Urban Health Services / organization & administration

Associated data